|
Hardening Of The Coronary Arteries Occurs During
Marital Disagreements
Main Category: Cardiovascular / Cardiology News
Article Date: 07 Mar 2006 - 17:00 PST
Hardening of the coronary arteries is more likely in wives when
they and their husbands express hostility during marital disagreements,
and more common in husbands when either they or their wives act
in a controlling manner.
Those are key findings of a study of 150 healthy, older, married
couples • mostly in their 60s • conducted by Professor
Tim Smith and other psychologists from the University of Utah. Smith
was scheduled to present the findings Friday March 3 in Denver during
the annual meeting of the American Psychosomatic Society, which
deals with the influence of psychological factors on physical health.
"Women who are hostile are more likely to have atherosclerosis
[hardening of the coronary arteries], especially if their husbands
are hostile too," Smith says. "The levels of dominance
or control in women or their husbands are not related to women's
heart health."
"In men, the hostility • their own or their wives hostility
during the interaction • wasn't related to atherosclerosis,"
he adds. "But their dominance or controlling behavior •
or their wives dominance • was related to atherosclerosis
in husbands." Smith summarizes: "A low-quality relationship
is a risk factor for cardiovascular disease."
Smith conducted the study with University of Utah psychologists
Cynthia Berg, a professor; Bert Uchino and Paul Florsheim, both
associate professors; and Gale Pearce, a Utah postdoctoral fellow
now on the faculty of Westminster College in Salt Lake City.
Marital Disputes in the Laboratory
The study • which began in 2002 and ended in 2005 •
involved 150 married couples with at least one member between 60
and 70 years of age and the other one no more than five years older
or younger. The couples were recruited through newspaper advertisements
and a polling firm. Those who participated had no history of cardiovascular
disease and were not taking medicine for it.
Each husband and wife was paid $150 to participate, and also received
free of charge a $300 CT scan to look for calcification in their
coronary arteries • the arteries that supply the heart muscle
and that can cause a heart attack when clogged. Smith says that
in otherwise healthy people, calcification represents hardening
and narrowing of the arteries that puts them at risk for later heart
attack.
Each couple was told to pick a topic • such as money, in-laws,
children, vacations and household duties • that was the subject
of disagreements in their marriage. Then, while sitting in comfortable
chairs and facing each other across a table, each couple discussed
the chosen topic for six minutes while they were videotaped.
Psychology graduate students coded the videotaped conversations
so that "each comment that reflected a complete thought"
was given a code indicating the extent to which it was friendly
versus hostile, and submissive versus dominant or controlling.
For example, comments like, "You can be so stupid sometimes"
or "you're too negative all the time," were coded as hostile
and dominant. Another dominant or controlling comment would be,
"I don't want you to do that; I want you to do this."
"A warm, submissive comment would be, 'Oh that's a good idea,
let's do it,'" Smith says. "A less warm one would be,
'If it's important to you, I'll do what you want.' An unfriendly,
submissive comment is, 'I'll do what you want if you get off my
back.'"
Smith says some of the marital discussions were calm and peaceful,
but in some cases, the couples were quite hostile, prompting the
psychology graduate students to refer them to marriage counseling.
The researchers assumed that a couple's behavior during the discussion
reflected their long-term pattern of behavior, although a marital
spat in front of researchers likely "is a muted version of
what goes on at home," Smith adds.
Two days after their discussion, each couple underwent a CT scan
of the chest at the University of Utah's Center for Advanced Medical
Technologies. Doctors used a standard scale to score each person's
level of coronary artery calcification • an indicator of atherosclerotic
plaque buildup in the arteries that supply blood to the heart.
Since the participants were healthy, none of the "silent"
atherosclerosis revealed by the CT scans amounted to a medical emergency.
"But there were people who had scores high enough they needed
to discuss it with their doctor, because statistically it placed
them at a high risk of a coronary event," Smith says.
Findings of the Study
The researchers found:
* The more hostile the wives' comments during the discussion, the
greater the extent of calcification or hardening of the arteries.
And "particularly high levels of calcification were found in
"women who behaved in a hostile and unfriendly way and who
were interacting with husbands who were also hostile and unfriendly."
* The extent to which either wives or husbands acted in a dominant
or controlling manner was unrelated to the severity of hardening
of the arteries in the wives.
* The extent to which wives or husbands spoke with hostility had
no relationship to the severity of hardening of the arteries in
the husbands.
* Husbands who displayed more dominance or controlling behavior
• or whose wives displayed such behavior • were more
likely than other men to have more severe hardening of the arteries.
"Another way to say it is that either being controlling or
being married to someone who is controlling is enough to promote
atherosclerosis in men," says Smith "So in couples where
there was not a struggle for control • where it wasn't a contest
• those men had much lower levels of atherosclerosis.
To sum it all up, hostility during marital disputes was bad for
women's hearts, while controlling behavior during marital disputes
was bad for men's hearts.
"Disagreements are an unavoidable fact of relationships,"
says Smith. "But the way we talk during disagreements gives
us an opportunity to do something healthy."
"If you were concerned about men's heart health, you would
ask couples to find ways to talk about disagreements without trying
to control each other. If you were concerned about women's heart
health, you would encourage couples to find ways to have disagreements
that weren't hostile."
And for spouses concerned about each other, avoid both hostility
and controlling behavior during disagreements, he adds.
Putting the Findings in Context
Previous research indicates "close relationships are good
for our heart health. Having relationships places you at lower risk
than feeling lonely and isolated," Smith says. But the new
study suggests "that the quality of those relationships is
important."
In addition, "the dimensions of quality that are important
differ for men and women. Conventional views of harmony versus discord
• how warm versus hostile interactions are • are indeed
important for women. But a different dimension of quality is more
important for men, and that has to do with power and control in
relationships."
Smith says a common factor is anger: wives' anger from feeling
hostility or being subject to hostility; and husband's anger from
experiencing or at least perceiving a challenge to their sense of
control.
That "certainly is consistent with a large body of prior literature
on emotions, relationships and health," he adds. "What's
novel about this study is taking a snapshot of how couples talk
to each other and relating that to a silent, progressive and potentially
deadly disease."
Smith also offers another caution about the findings.
"People get heart disease for lots of reasons," he says.
"If someone said, 'What's the most important thing I can do
to protect my heart health?' my first answers would be, 'Don't smoke,'
'Get exercise' and 'Eat a sensible diet.' But somewhere on the list
would be, 'Pay attention to your relationships.'"
###
University of Utah Public Relations
201 S Presidents Circle, Room 308
Salt Lake City, Utah 84112-9017
www.utah.edu/unews
Contact: Tim Smith, professor of psychology
tim.smith@psych.utah.edu
Lee Siegel, science news specialist
leesiegel@ucomm.utah.edu
University of Utah Public Relations
Cholesterol linked with prostate cancer
outcome
Last Updated: 2006-11-16 15:09:42 -0400
(Reuters Health)
NEW YORK (Reuters Health) - Men with low cholesterol
have a reduced risk of developing more aggressive forms of the prostate cancer, but not a lower risk of developing prostate
cancer overall, compared with men with higher cholesterol levels.
The findings, reported at a cancer prevention conference in Boston
this week, may help explain the findings of an earlier study by
some of the same researchers in which men who took cholesterol-lowering
statin drugs had half the risk of advanced prostate cancer and one
third the risk of fatal prostate cancer, compared with men who did
not take these drugs.
Statin drugs reduce cholesterol in the blood, but they also influence
a number of different pathways, possibly related to prostate carcinogenesis,
study chief Elizabeth Platz from Johns Hopkins Bloomberg School
of Public Health in Baltimore noted at the conference. Some scientists
theorize that abundant cholesterol in the blood could help abnormal
prostate cells survive longer.
Platz and associates analyzed stored blood drawn between 1993 and
1995 from 698 men before they were diagnosed with prostate cancer
and the matched these samples to blood drawn during the same period
from another 698 men who did not develop prostate cancer.
All of the men are part of the ongoing Health Professionals Follow-up
Study, initiated in 1986 to look at lifestyle factors related to
cancer and other chronic diseases.
According to Platz, average cholesterol levels did not differ between
men with prostate cancer and those without, which suggests that
cholesterol is not involved in the initiation of the disease.
However, on further analysis, they found that men with the lowest
cholesterol levels, compared with those with the highest, had a
40-percent lower risk of high-grade prostate cancer -- a more worrisome
form of the disease.
Similarly, men with the lowest cholesterol levels had a 50-percent
lower risk of advanced prostate cancer. Low cholesterol was defined
as 165 milligrams per deciliter of cholesterol.
"In a sub-analysis, we excluded men who were taking any type of
cholesterol-lowering drug and our results persisted," Platz said.
"The results of the present study," the authors conclude, "coupled
with our finding for statins, suggest a line of mechanistic studies
on cholesterol intake and metabolism that should be pursued" to
better understand how to prevent prostate cancers from having a
poor prognosis.
Copyright © 2006 Reuters Limited. All rights
reserved. Republication or redistribution of Reuters content, including
by framing or similar means, is expressly prohibited without the
prior written consent of Reuters. Reuters shall not be liable for
any errors or delays in the content, or for any actions taken in
reliance thereon. Reuters and the Reuters sphere logo are registered
trademarks and trademarks of the Reuters group of companies around
the world.
High Cholesterol Linked To Raised Prostate Cancer Risk
Main Category: Prostate News
Article Date: 13 Apr 2006 - 10:00 PST
According to a study carried out at the Istituto di Ricerche Farmacologiche
Mario Negri Milan, Italy, men who have high (bad) cholesterol levels
have a higher risk of developing prostate cancer. The scientists
said more research is needed after carrying out a study on 2,745
men - of whom 1,294 had prostate cancer, while the rest had non-cancerous
conditions for which they went to hospital.
The study found that men with prostate cancer have a 50% higher
probability of having raised cholesterol levels. For those men under
50 and over 65 the likelihood of raised cholesterol levels was 80%.
While the Italian researchers think that the reason for the higher
prostate cancer risk may be because the body produces more hormones
when cholesterol levels are higher (cholesterol us utilized to make
more hormones), many experts disagree.
Those who disagreed pointed to diet, which can affect cholesterol
levels and prostate cancer risk (indicating that perhaps diet raises
prostate cancer risk as well as high cholesterol levels). Incidences
of prostate cancer are higher in northern Europe, where men consumer
more animal fats, than southern Europe, where men consume more plant
based fats, such as olive oil. Cholesterol levels are lower in southern
Europe.
In Other Words
Some believe diet may be raising prostate cancer levels and cholesterol
levels independently.
An extreme analogy
Imagine every car in the country had to have a blue flag on top.
And then a scientist notices that more people die when they are
near blue flags and concludes that blue flags may be killing people.
Others may disagree and say that the cars make the blue flags move
and raise the risk of human deaths (car accidents) independently.
(Obviously, in this case, the conclusions of both: those who think
cholesterol is causing the cancer and those who think diet is, are
valid - until further research is carried out.) Rather than checking
the participants themselves, the researchers used data sent to them
from the participants.
The link between high cholesterol and prostate cancer risk is evident,
say the scientist. They also checked for several other medical conditions
and found no link.
You can read about this study in the Annals of Oncology
Written by: Christian Nordqvist
Editor: Medical News Today
Study Shows Prostate Cancer Vaccine Linked To Longer Survival
Main Category: Prostate News
Article Date: 03 Jul 2006 - 3:00 PST
A University of California, San Francisco study has found that men
with advanced, often untreatable prostate cancer who received a
therapeutic cancer vaccine went on to survive longer than those
receiving a placebo.
Study findings showed the vaccine group lived up to an average
of four-and-a-half months longer and had a greater than three-fold
increase in survival at 36 months when compared to patients in the
placebo group.
The study is reported in the July 1, 2006 issue of the Journal
of Clinical Oncology.
The double-blind, placebo-controlled phase III clinical trial was
conducted to test the efficacy of the vaccine, called sipuleucel-T,
in delaying disease progression and prolonging survival in patients
with asymptomatic metastatic hormone refractory prostate cancer
(HRPC).
Study results showed that the vaccine was well-tolerated by participants.
The most common reported adverse effects such as fever and chills
were typically mild.
Led by Eric J. Small, MD, UCSF professor of medicine and urology,
the study was conducted in collaboration with 19 institutions in
the United States and funded by the Dendreon Corporation, a biotechnology
company that developed the vaccine.
"This trial is an important milestone in the development of
new treatments for prostate cancer patients," said Small. "The
potential survival benefit that was observed may offer important
benefits to patients and would represent the first time that immunotherapy
has provided a survival advantage in prostate cancer."
Sipuleucel-T, known by its product name Provenge, is an investigational
immunotherapy vaccine designed to stimulate T-cell immunity to prostatic
acid phosphatase, an antigen found in about 95 percent of prostate
cancers but not in non-prostate tissue.
A total of 127 patients with asymptomatic metastatic HRPC received
three transfusions of sipuleucel-T or placebo every two weeks. Of
this group, 115 patients had progressive disease at the time of
data analysis and all patients were followed for survival for 36
months.
Prostate cancer is the most common non-skin cancer in the U.S.
with more than 200,000 new cases each year. It is the third leading
cause of cancer deaths in men after lung and colorectal cancer.
Unlike prostate cancer that is detected early, asymptomatic metastatic
HRPC is resistant to traditional hormonal therapy, and treatment
options have been limited.
The study showed that the median overall survival was 25.9 months
for sipuleucel-T-treated patients and 21.4 months for placebo-treated
patients. After three years, survival was 34 percent for those treated
with the vaccine compared to 11 percent for those taking the placebo.
The clinical trial did not meet its primary endpoint of demonstrating
a statistically significant difference in progression of the disease
from diagnosis, according to Small.
"We found that the time to disease progression for sipuleucel-T
was 11.7 weeks compared to 10.0 weeks for placebo," he said.
"This shows the difficulties in using the worsening of the
disease as an intermediate marker for overall survival of patients
treated with immunotherapy. The study however, suggests that sipueucel-T
may provide a survival advantage to asymptomatic HRPC patients."
Many of the phase I and II clinical trials of the vaccine were
also undertaken at UCSF and led by Small. He first presented results
from the phase III trial at the 2005 meeting of the American Society
of Clinical Oncology.
Dendreon Corporation, based in Seattle, Washington, hopes to market
the Provenge product commercially in the coming year.
###
Co-authors of the study are Paul F. Schelhammer, Eastern Virginia
Medical School, Norfolk, VA; Celestia S. Higano, University of Washington;
Charles H. Redfern, Sharp Healthcare, San Diego; John J. Nemunaitis,
Mary Crowley Medical Research Center, Dallas; and Frank H. Valone,
Suleman S. Verjee, Lori A. Jones and Robert M. Hershberg, Dendreon
Corporation.
UCSF is a leading university that consistently defines health care
worldwide by conducting advanced biomedical research, educating
graduate students in the life sciences, and providing complex patient
care.
Contact: Nancy Chan
University of California - San Francisco
|
